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LONG-TERM ANALYSIS OF RECONSTRUCTED TEMPOROMANDIBULAR JOINT AND MANDIBLE USING FREE FIBULAR FLAP (비골 피판을 이용한 하악 및 하악과두 재건의 장기간 임상적 평가)

  • Ahn, Kang-Min;Chung, Hun-Jong;Ryom, Hak-Ryol;Kim, Hang-Jin;Kim, Yoon-Tae;Hwang, Soon-Jung;Myoung, Hoon;Kim, Myung-Jin;Kim, Soung-Min;Jahng, Jeong-Won;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.5
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    • pp.409-416
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    • 2005
  • Purpose of study: The temporomandibular joint (TMJ) occupies a key functional role in mastication and contributes to normal deglutition, speech as well as cosmesis. When a large amount of mandible including the condyle head is resected, it is very difficult to reconstruct it as a functional unit. In this retrospective study, we present the functional, radiographic and cosmetic results of reconstructed temporomandibular joint using free fibular flap. Patients and Methods: Total 12 patients (M:F = 6:6) who underwent condylar reconstruction with the fibular flap were interviewed and examined by radiographs and Bio-PAK$^{(R)}$. Mean follow up periods was $47.7{\pm}20.0$ months and the average age was $38.7{\pm}15.3$ years. Remodeling of condyle and function of TMJ were evaluated and facial contour was judged subjectively. Results: All flaps were viable and no immediate postoperative complication had happened. One patient showed decreased mouth opening, so interpositional gap arthroplasty was performed. The resorption rates of reconstructed fibular were minimal and the condyle heads were changed into domeshaped neocondyle after 2 years. All patients had normal diet and no speech difficulty was reported. Nine patients were satisfied with their facial contour but three patients complained about the depression of cheek. Conclusion: The reconstruction of TMJ with free fibular flap was reliable methods and very effective means of restoring mandibular function. The functional and morphologic results were excellent and showed little complications.

Antibody response to pneumococcal vaccination in children with chronic or recurrent rhinosinusitis

  • Baek, Ji Hyeon;Seo, Hyun Kyong;Jee, Hye Mi;Shin, Youn Ho;Han, Man Yong;Oh, Eun Sang;Lee, Hyun Ju;Kim, Kyung Hyo
    • Clinical and Experimental Pediatrics
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    • v.56 no.7
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    • pp.286-290
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    • 2013
  • Purpose: Although chronic and recurrent rhinosinusitis is prevalent in children, little is known about its causes. Here, we investigated the humoral immunity in children with chronic or recurrent rhinosinusitis. Methods: We examined 16 children attending the outpatient clinic at the CHA Bundang Medical Center including 11 boys and 5 girls, aged 3-11 years (mean age, 5.6 years), who had rhinosinusitis for >3 months or >3 times per year. The complete blood count with differential and total serum concentrations of Immunoglobulin (Ig) E, IgA, IgD, IgM, IgG, and IgG subclasses ($IgG_1$, $IgG_2$, $IgG_3$, and $IgG_4$) of all children were measured. All subjects received 23-polysaccharide pneumococcal vaccination (PPV), and the levels of antibodies to 5 serologic types (4, 6B, 14, 18C, and 23F) of pneumococcal capsular polysaccharide antigens were measured before and after vaccination. Post-PPV antibody titers ${\geq}0.35{\mu}g/mL$ or with a ${\geq}4$-fold increase were considered as positive responses. Results: The titers of IgG, IgA, IgD, and IgM were within normal range in all 16 children, whereas the total IgE concentration was higher than normal in 2 children. $IgG_1$ deficiency was observed in 1 patient and $IgG_3$ deficiency in 3. After PPV, 1 patient failed to respond to all 5 serologic types, 2 failed to respond to 4 serologic types, and 2 failed to respond to 3 serologic types. Conclusion: Clinicians should consider the evaluation of humoral immune functions in children with chronic or recurrent rhinosinusitis who do not respond to prolonged antibiotic treatment.

A Study on the Job-Santisfacion and Its Depressive Facors in Human Relation Among Operation Room Nurses (수술실 간호사의 인간관계 만족도와 저해요인에 관한 연구)

  • Cho, Mi-Ja
    • The Korean Nurse
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    • v.32 no.4
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    • pp.48-62
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    • 1993
  • This study was done for the purpose of analyzing the job-satisfaction and its depressive factors in human relation of operating room nurses of university hospital. Therfore, it makes an offer the basic data to help the resolution and prevention of the problems in operating room nurses. Furthermore, this study was conducted in order to find out some kinds of scientific data for the better control of depressive factors of job-satisfaction expressed by the operating room nurses. The structred questionaire reports of 246 operating room nurses who were employed in 5 different university hospitals which have over 1, 000 beds located in Seoul, Korea were used, which wer collected from August 24th to August 30th of 1992. The author visited supervisors of operating room in each university hospital and explained the aim of this study. The most of them(90.0%) answered to the questionaires. Analysis of the collected data were done by mean, standard deviation, percentage, t-test, F-test, Q-test, correlation analysis, one-way ANOVA.and stepwise multiple regression analysis. Major findings of this study were as follows: 1. The job of the operating room nurses were remarkably related with the satisfaction in human relation, which was defined as the behavioral job with thoughtful action rather than with mechanical action. However, the degree of satisfaction in human relation with personnel in other departments was found to be the lowest and its the main depressive factors were appeared due to the absence of interaction and uncooperative attitudes. Therefore, it was required that the members of other job need more cooperative attitude to the actual works in the operating room nurses. 2. The depressive factors in the satisfaction degree of human relation with offical seniors wer significantly related with their irresponsibility and partialness. Moreover, the job attitude of the operating room nurses is abundantly required to be improved, 3. The depressive factors in the satisfaction of human relation with medical doctors were significantly related with their insincerity and the class-consciousness. It is clearly suggested that the medical doctors do more cooperative behaviors for the jobs of the operating room without the suggested that the medical doctors do more cooperative behaviors for the jobs of the operating room without the superiority feeling of class-consciousness. 4. There was a significantly positive association between the satisfaction degree of human relation of the nurses with the following charateristics. (1) The registered nurses which had a tendency to be satisfied about the registered nurses' job. (2) The registered nurses which had a tendency to be a technique-aptitued in the motivation of the registered nurses'job. (3) The registered nurses which had a tendency to be satisfied about the total hospital working carrier and the aspects of old ages. Finally, these findings indicated that the operating room nurses should require the professional education courses associated with a high-development techniques and setisfaction in their jobs.

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Comparison of the prevalence of 4 periodontopathogens in supra-and subgingival plaque of young adults without periodontitis (치주질환이 없는 청년의 치은연상 및 치은연하 치면세균막에 존재하는 치주질환 관련 4종 세균의 분포 비교)

  • Jang, Hyun-Seon;Kim, Ji-Yeon;Kook, Joong-Ki;Yoo, So-Young;Kim, Hwa-Sook;Kim, Su-Gwan;Kim, Byung-Ock
    • Journal of Periodontal and Implant Science
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    • v.33 no.2
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    • pp.159-166
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    • 2003
  • The purpose of this study was to investigate and compare the frequence of 4 periodontal pathogens in the supra- and subgingival plaque in periodontally healthy subjects. Twenty adult individuals aged 22 to 28 years (mean age 23.65 years) participated in this study. All subjects had no pocket sites more than 3 mm deep, and the sites selected for sampling were all negative for bleeding. After drying and isolation of the sites with cotton rolls, supragingival plaque was sampled using sterile periodontal curette. Each plaque sample was placed in individual tubes containing 500 ml of 1X PBS. After removal of the supragingival sample and any remaining supragingival plaque, subgingival plaque samples were taken from the same sites using sterile curette and placed in similar individual tubes. Identification of 4 putative periodontal pathogens from the samples was performed by polymerase chain reaction based on 16S rDNA. Chi-square test was employed to identify significant explanatory variables for the presence of the 4 periodontal pathogens. The data show that Actinobacillus actinmycetemcomitans, Porphyromonanas gingivalis, Bacteroides forsythus, and Fusobacterium nucleatum occurred in 16.9%, 14.4%, 52.5%, and 80.6%, respectively. No significant differences were noted in the periodontal pathogens between supra- and subgingival plaques according to the kind of teeth. However, the incisors were at higher risk for harboring F. nucleatum (p <0.05). Conclusion: These results reveal that anaerobic periodontal pathogens can be detected in supragingival plaques. Supragingival plaque may function as a reservoir of peri-odotopathogens.

Radiation Therapy for Primary Eyelid Cancers in Tunisia

  • Belaid, A;Nasr, C;Benna, M;Cherif, A;Jmour, O;Bouguila, H;Benna, F
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3643-3646
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    • 2016
  • Management of eyelid cancers is based on surgery and/or radiotherapy (RT). The treatment objective is to control tumors with acceptable functional and esthetic outcomes. The aim of this study was to evaluate the results of radiation therapy in management of epithelial eyelid cancers, reviewing retrospectively the clinical records of patients treated in our institution from January 1989 to December 2013. We focused on clinical and histological features, treatment characteristics, tolerance and disease control. One hundred and eight patients (62 men and 46 women) were enrolled, with a mean age of 61 years [ranges 15-87]. The most frequent tumor location was the inner canthus (42.6%). Median tumor size was 21 mm [ranges 4-70]. Histological type was basal cell carcinoma in 88 cases (81.5%), squamous cell carcinoma in 16 (14.8%) and sebaceous carcinoma in 4 (3.7%). Radiation therapy was exclusive in 67 cases (62%) and post-operative for positive or close margins in the remaining cases. Kilovoltage external beam radiotherapy (KVRT) was used in 63 patients (58.3%) and low-dose-rate interstitial brachytherapy in 37 (34.3%). Eight (7.4%) were treated with cobalt or with a combination of KVRT-cobalt, KVRT-electron beams, KVRT-brachytherapy or cobalt-electron beams. The total delivered radiation doses were 70 Gy (2 Gy/fraction) in 62 patients (57.4%), 66 Gy (2 Gy/fraction) in 37 (34.3%) and 61.2 Gy (3.4Gy/fraction) in 9 (8.3%). After a median follow-up of 64 months, we noted 10 cases of local recurrences(9.2%): 7 after exclusive and 3 after post-operative RT. No local recurrence occurred in patients treated with brachytherapy. Actuarial 5-year local recurrence-free rate, disease-free survival and overall survival were respectively 90%, 90% and 97%. T-stage was found to be a significant factor for recurrence (p=0.047). All acute radiation-related reactions were scored grade I or II. Delayed effects were eye watering in 24 cases (22.2%), eye dryness in 19 (17.6%), unilateral cataract in 7 (6.4%) and ectropion in 4 (3.7%). Radiation therapy and especially brachytherapy is an efficient treatment of eyelid cancers, allowing eye conservation and functional preservation with good local control rates and acceptable toxicity.

Comparison of Indigenous Browses and Sunflower Seed Cake Supplementation on Intake and Growth Performance of Dual-purpose Goats Fed Buffel Grass (Cenchrus ciliaris) Hay

  • Komwihangilo, D.M.;Chenyambuga, S.W.;Lekule, F.P.;Mtenga, L.A.;Muhikambele, V.R.M.
    • Asian-Australasian Journal of Animal Sciences
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    • v.18 no.7
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    • pp.966-972
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    • 2005
  • A study to compare the effects of supplementing Delonix elata, Grewia similis, Tamarindus indica and sunflower seed cake on intake and growth rate of dual-purpose goats fed low quality Buffel grass (Cenchrus ciliaris) hay was carried out. Twenty-eight male goats aged five to seven months (mean weight 12.93${\pm}$3.94 kg) were randomly allocated to four dietary groups in a completely randomised design. The diets were hay plus Grewia similis, hay plus Delonix elata, hay plus Tamarindus indica and hay plus sunflower seed cake. All diets were supplemented with maize bran. The experimental period was 90 days. Voluntary dry matter intake of the supplements was higher for Tamarindus indica (275.5 g/day) and Grewia similis (201.8 g/day) and lowest for sunflower seed cake (81g/day). Goats supplemented with Grewia similis had the highest hay intake (183.8 g/day) while those supplemented with sunflower seed cake had the lowest hay intake (98.9 g/day). Animals fed browse supplements gained significantly more weight (p<0.001) than those with sunflower seed cake. There were no significant differences in live weight change between goats fed the different browses. However, those fed Tamarindus indica gained an average of 20.79 g/d which was slightly higher than the gains for those on Grewia similis and Delonix elata while those fed sunflower seed cake lost weight. Correspondingly, goats supplemented with browse leaf meals had higher feed conversion ratios than those supplemented with sunflower seed cake and required 23.91 to 35.06 g DM of feed to produce one g of weight gain per day. In a separate study, the DM disappearance pattern indicated that Grewia similis and Delonix elata were highly degradable compared to Tamarindus indica. At 24 h of incubation, DM degradability was 627, 588 and 345 g/kg DM for Grewia similis, Delonix elata and Tamarindus indica, respectively. In another study in vivo DM digestibility ranged from 46.1% (for hay alone) to 56.2% (for hay plus Grewia similis). It was concluded that the addition of Tamarindus indica, Grewia similis and Delonix elata leaf meals to Cenchrus ciliaris hay resulted in increased total DM intake, in vivo digestibility and growth rate. Therefore, leaf meals of indigenous browses particularly Tamarindus indica and Grewia similis could be used as supplementary feeds for small ruminants grazing on poor quality roughages during the dry season rather than use of expensive, less effective and intermittently available sunflower seed cake.

Diagnostic Usefulness of FDG-PET in Cervical Metastasis of Squamous Cell Carcinoma of the Head and Neck (두경부 편평세포암종의 경부 전이에 대한 F-18 FDG PET의 진단적 유용성)

  • Kim Chan-Jong;Kim Jae-Seung;Kang Woo-Seuk;Nam Soon-Yuhl;Choi Seung-Ho;Kim Sang-Yoon
    • Korean Journal of Head & Neck Oncology
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    • v.19 no.2
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    • pp.142-147
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    • 2003
  • Purpose: Accurate evaluation of metastatic cervical lymph nodes plays a decisive role in the treatment and prognosis of patients with squamous cell carcinoma of the head and neck. The purpose of this study is to investigate the usefulness of FDG-PET for diagnosis of cervical metastasis in the head and neck cancer by comparing with the conventional imaging study. Materials and Methods: The subjects on this study were 30 patients (24 males and 6 females, aged 39 to 76, mean 57.1) diagnosed as pathologic-proven squamous cell carcinomas of the head and neck. All patients underwent preoperative FDG-PET, CT(n=27) or MRI (n=3). Their medical records were reviewed retrospectively. Using pathologic reports as a golden standard, the results of FDG-PET were compared with conventional imaging study (CT/MRI) in the evaluation of cervical metastasis. Results: Thirty patients had five different primary sites which were tongue (11), supraglottis (10), glottis (6), hypopharynx (2) and tonsil (1). A total of 40 neck dissections were performed unilaterally in 20 patients and bilaterally in 10 patients. Of these, 16 showed pathologically positive for lymph node metastasis. The sensitivity and specificity of FDG-PET for the diagnosis of cervical metastasis was 75% and 100% respectively, compared with conventional imaging of 56.3% and 95.8%, respectively. The difference of sensitivity was not statistically significant (p=0.453). Of 5 cases with small metastatic node (<1cm), 3 were detected on PET detected correctly but none were detected by CT. Conclusion: FDG-PET was more accurate than conventional imaging study in the diagnosis of metastatic lymph nodes in squamous cell carcinomas of the head and neck, especially detection of small metastatic node. FDG-PET might be useful adjunct to conventional image in the preoperative evaluation of head and neck squamous cell carcinoma.

Comparison of the accuracy of digitally fabricated polyurethane model and conventional gypsum model

  • Kim, So-Yeun;Lee, So-Hyoun;Cho, Seong-Keun;Jeong, Chang-Mo;Jeon, Young-Chan;Yun, Mi-Jung;Huh, Jung-Bo
    • The Journal of Advanced Prosthodontics
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    • v.6 no.1
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    • pp.1-7
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    • 2014
  • PURPOSE. The accuracy of a gypsum model (GM), which was taken using a conventional silicone impression technique, was compared with that of a polyurethane model (PM), which was taken using an iTero$^{TM}$ digital impression system. MATERIALS AND METHODS. The maxillary first molar artificial tooth was selected as the reference tooth. The GMs were fabricated through a silicone impression of a reference tooth, and PMs were fabricated by a digital impression (n=9, in each group). The reference tooth and experimental models were scanned using a 3 shape convince$^{TM}$ scan system. Each GM and PM image was superimposed on the registered reference model (RM) and 2D images were obtained. The discrepancies of the points registered on the superimposed images were measured and defined as GM-RM group and PM-RM group. Statistical analysis was performed using a Student's T-test (${\alpha}=0.05$). RESULTS. A comparison of the absolute value of the discrepancy revealed a significant difference between the two groups only at the occlusal surface. The GM group showed a smaller mean discrepancy than the PM group. Significant differences in the GM-RM group and PM-RM group were observed in the margins (point a and f), mesial mid-axial wall (point b) and occlusal surfaces (point c and d). CONCLUSION. Under the conditions examined, the digitally fabricated polyurethane model showed a tendency for a reduced size in the margin than the reference tooth. The conventional gypsum model showed a smaller discrepancy on the occlusal surface than the polyurethane model.

The Relationship Between the Empowerment and the Job Satisfaction of 119 Emergency Medical Technician (119 구급대원의 임파워먼트와 직무만족과의 관계)

  • Han, Song-Yi
    • The Korean Journal of Emergency Medical Services
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    • v.14 no.1
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    • pp.47-63
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    • 2010
  • Objective : The objective of this study was to survey the job-related empowerment and job satisfaction of 119 emergency medical technicians provide emergency patients with first aid, to examine the correlation between their empowerment and job satisfaction, and to provide basic materials for developing programs to enhance 119 emergency medical technicians' empowerment and job satisfaction. Methods : The survey was conducted with 249 119 emergency medical technicians working at fire stations in an area of Gyeonggi-do during the period from June 26 to August 21, 2009. Using SPSS 14.0 program, we obtained frequencies percentages, means, and standard deviations, and performed independent two sample t-test, one way ANOVA, and Pearson correlation analysis, and Cronbach's ${\alpha}$. Results : 1) The mean score of the subjects' empowerment was 3.32, and that of their job satisfaction was 2.94. 2) As to difference according to general characteristics, no statistically significant difference was observed in empowerment but job satisfaction was statistically significantly different according to gender(t = 2.296, p = .023). 3) As to difference according to job related characteristics, empowerment was significantly different according to license type(F = 3.767, p = .011), and job satisfaction was statistically significantly different according to position(t = 3.222, p = .042), fire fighting experience(t = 2.689, p = .035), and first aid experience(t = 3.991, p = .007). 4) Empowerment was in a positive correlation with job satisfaction(r = .502, p = .000) in general, and by the sub areas of job satisfaction, the correlation with empowerment was high in order of job itself(r = .695, p = .000), interaction area(r = .493, p = .000), organizational demand area(r = .328, p = .000), working condition area(r = .153, p = .015), and wage area(r = .137, p = .031). By the sub areas of empowerment, the correlation with job satisfaction was high in order of significance(r = .424, p = .000), influence(r = .397, p = .000), competence(r = .372, p = .000), and self determination(r = .259, p = .000). Conclusion : The 119 emergency medical technicians' empowerment was in a high correlation with their job satisfaction, and had a strong effect on it. This suggests that 119 emergency medical technicians' job performance can be enhanced by improving their empowerment. These results are expected to be useful in making human resource management plans to enhance 119 emergency medical technicians' job satisfaction by empowering them.

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Treatment Results of Multidrug Resistant Tuberculosis in a University Hospital in Korea (다제내성 결핵의 치료 성적)

  • Yum, Ho-Kee;Song, Yeong-Su;Choi, Sao-Jean;Lee, Bong-Choon;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.862-870
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    • 1996
  • Background : Multidrug-resistant tuberculosis(MDR-Tb) has been increased not only in Asia but also in Western society, which may cause public health problems and reduce the efficacy of treatment of tuberculosis. In Western society HIV infection is believed to do a central role in increasing incidence of MDR tuberculosis, but MDR-Tb in Korea may be somewhat different about clinical features, underlying disorders, and prognosis. Goble et al reponed that overall treatment failure rate in MDR-Tb including resistance to isoniazid(INH) and rifampin (RFP) was 44 %. The aim of this study is to find the treatment result in Korea and the factors determining the prognosis. Methods: A retrospective study of pulmonary tuberculosis cultured M. tuberculosis from sputum or bronchial washing fluid between 1986 through 1992 was conducted in the Seoul Paik Hospital, Inje University. We reviewed clinical courses of 141 patients, who had a tuberculosis with resistance to 2 or more drugs including isoniazid(INH) and rifampin(RFP). One hundred and 4 patients of 141 patients had completed treatment and followed up for more than one year. Results: Of 104 (mean age $43.6{\pm}16.7$, M: F=63 : 41) patients with sufficient follow-up data, 73(84.6%) patients responded which is defined as negative Sputum cultures for at least 3 consecutive months. Seven patients(6.7%) had a failure in negative conversion and 9(8.7%) of the patients who initially responded relapsed. Overall treatment failure rate was 15.4%, Patients who were treated for less than 12 months had a higher relapse rate(12.3%) than 18 months(4.9%). And there was a statistically significant correlation between the relapse rate and the number of drugs to which isolates wera resistant(p<0.05). Conclusion : The treatment failure rate of MDR-Tb in Korea was lower than previous studies in western Country and the major determining factor of prognosis was the number of resistant drugs to M. tuberculosis at drug sensitivity test. For reducing the relapse rate, we recommend more than 12 months of treatment for MDR tuberculosis.

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